Sunday, December 1, 2019

The holiday season can be
a stressful time of year for everyone, especially for parents of children on the autism spectrum. The sights and sounds of the holidays can be
stressful and over-stimulating. There are many changes in routine, family events,
parties, and vacations that need to be planned. Sometimes the stress of these
changes can become overwhelming and the joy and happiness of the holidays might
be lost. Here are some helpful tips to lessen your child’s anxiety and increase
your family’s enjoyment of the holiday season:

Decorating and Shopping

If your child has difficulty with change, you may want to gradually
decorate thehouse. Decorate in stages, rather than all
at once. It may also be helpful to develop a visual schedule
or calendar that shows what will be done on each day.

Allow your child to interact with the decorations and help put them in
place.

Flashing lights or musical decorations can disturb some children. To
see how yourchild will respond, provide an opportunity
experience these items in a store or atelsewhere first.

Last minute holiday shopping can be stressful for children who rely on
routines. Ifyou do take your child shopping, allow enough
time to gradually adapt to the intenseholiday stimuli that stores exhibit this
time of year.

Family Routines and Travel

Meet as a family to discuss how to minimize disruptions to established
routines and how
to support positive behavior when disruptions
are inevitable.

Continue using behavior support strategies during the holidays. For
example, use social stories to help your child cope
with changes in routine and visual supports to help prepare for more complicated days.

Use a visual schedule if you are celebrating the holidays on more than
one day toshow when there will be parties/gifts and when
there will not.

Use rehearsal and role play to give children practice ahead of time in
dealing withnew social situations, or work together to
prepare a social story that incorporates allthe elements of an upcoming event or visit
to better prepare them for that situation

If you are traveling for the holidays, make sure you have child’s
favorite foods, booksor toys available. Having familiar items readily
available can help to calm stressfulsituations.

If you are going to visit family or friends, make sure there is a quiet,
calm place to goto
if needed. Teach your child to leave a situation and/or how to access support
whena situation becomes overwhelming. For
example, if you are having visitors, have aspace set aside for the child as his/her
safe/calm space. He or she should be taughtahead of time that they should go to their
space when feeling overwhelmed. This self-management strategy will also be helpful in
future situations.

Gifts and Play Time

If you put gifts under the Christmas tree, prepare well ahead of time
by teaching that gifts are not to be opened without the family
there. Give your child a wrapped and
a reward for keeping it intact.

Practice unwrapping gifts, taking turns and waiting for others, and
giving gifts. Role play
scenarios with your child in preparation for him/her getting a gift they may
notwant

Take toys and other gifts out of the box before wrapping them. It can
be more fun andless frustrating if your child can open
the gift and play with it immediately.

When opening gifts as a family, try passing around an ornament to
signal whose turnit is to open the next gift. This helps alleviate
disorganization and the frustration ofwaiting.

Prepare siblings and young relatives to share their new gifts with
others.

If necessary, consider giving your child a quiet space to play with
his/her own gifts,away from the temptation of grabbing at other
children’s toys

Prepare family members for strategies to use to minimize anxiety or
behavioralincidents, and to enhance participation. Provide
suggestions ahead of time that willmake for a less stressful holiday season.

Keep an eye out for signs of anxiety or distress, including an
increase in behavior such
as humming or rocking - this may indicate it's time to take a break from theactivity.

Understand how much noise and other sensory input your child can
manage. Know their level of anxiety and the amount of preparation
it may require.

Try to relax and have a good time. Do everything possible to help
reduce the stresslevel for your child and family during the
holidays. If you are tense your child maysense that something is wrong. Don’t
forget to prepare yourself! A calm and collected parent
is better able to help their family enjoy this wonderful time of year.

Friday, November 29, 2019

Children with autism
spectrum disorders (ASD) frequently have co-occurring (comorbid) psychiatric
conditions, with estimates as high as 70 to 84 percent. A Comorbid disorder is
defined as a disorder that co-exists or co-occurs with another diagnosis so
that both share a primary focus of clinical and educational attention. Although
anxiety is not a defining characteristic of ASD, prevalence rates are significantly
higher in children with ASD than in typically developing children, children with
language disorders, chronic medical conditions, disruptive behavior disorders,
and intellectual disability or epilepsy. In fact, research suggests that
approximately one-half of children with ASD would meet the criteria for at
least one anxiety disorder. Several studies have also reported a bidirectional association
between internalizing disorders and autistic symptoms. For example, both a
higher prevalence of anxiety disorders has been found in ASD and a higher rate
of autistic traits has been reported in youths with mood and anxiety disorders.
Individuals with ASD also appear to display more social anxiety symptoms compared
to typical control individuals, even when these symptoms are clinically
overlapping with the characteristic social problems typical of ASD. With
comorbidity rates so elevated in the ASD population, treatment options for
anxiety have become increasingly important.

Cognitive-Behavioral Therapy

There is a strong evidence
base for the use of cognitive-behavioral therapy (CBT) interventions for
depression and anxiety in non-ASD populations. There are a variety of CBT
approaches, but most share some common elements. The primary goals of
traditional CBT are to identify and challenge dysfunctional beliefs,
catastrophic cognitions, and automatic thoughts as well as change problematic
behavior. With a therapist’s help, the individual is encouraged to challenge his
or her beliefs and automatic thoughts through a variety of techniques. Through
CBT, the individual learns skills to modify thoughts and beliefs, as well as
problem-solving strategies to improve interaction with others in effective and
appropriate ways, thereby promoting self-regulation.

CBT models for the
treatment of anxiety attempt to create a new coping pattern by using behavioral
techniques such as modeling, exposure, and relaxation as well as cognitive
techniques addressing cognitive distortions and deficiencies. These treatment
models generally emphasize four critical components of therapy: assessment,
psychoeducation, cognitive restructuring, and exposure. Using these four
components, CBT has been shown to be an empirically supported treatment for
typically developing children with anxiety issues. The most commonly used
techniques to treat anxiety in children are exposure, relaxation, cognitive
restructuring, and modeling in that order.

Cognitive-Behavioral Therapy for ASD

Although CBT has been
shown to be an effective empirically supported treatment for typical children,
there is a question as to whether or not it can be used with other populations.
In recent years, there have been a number of attempts to adapt CBT for children
and teens on the autism spectrum. Although there is no agreed upon set of
modifications, there appears to be a general consensus that with certain
specific modifications, CBT can be used to effectively lessen anxiety symptoms in
higher functioning children with ASD. Evidence from the current literature
supports a specific blend of techniques and strategies as the most effective
approach to modify CBT for use with children who have an ASD. The primary
modifications to CBT that have been shown to make them more viable for anxious
children with ASD are the development of disorder specific hierarchies, the use
of more concrete, visual tactics, the incorporation of child specific
interests, and parent participation.

A study published in the Journal
of Child Psychology and Psychiatry illustrates how a standard CBT program
can be adapted to include multiple treatment components designed to accommodate
or remediate the social and adaptive skill deficits of children with ASD that
serve as barriers to anxiety reduction. The study tested a modular CBT program incorporating
separate modules focusing specifically on deficits associated with ASD such as
poor social skills, self-help skills, and stereotypies as well as a modified
version of a traditional CBT protocol utilizing primarily cognitive
restructuring and exposure techniques. The participants were forty children
(7–11 years of age) who met the criteria for ASD and one of the following
anxiety disorders: separation anxiety disorder (SAD), social phobia, or
obsessive-compulsive disorder (OCD). They were randomly assigned to 16 sessions
of CBT or a 3-month waitlist (36 children completed treatment or waitlist). The
CBT model emphasized coping skills training (e.g., affect recognition,
cognitive restructuring, and the principle of exposure) followed by in vivo
exposure. The parent training components focused on supporting in vivo
exposures, positive reinforcement, and communication skills. Independent
evaluators blind to treatment condition conducted structured diagnostic
interviews and parents and children completed anxiety symptom checklists at
baseline and posttreatment/postwaitlist. The researchers found that 92.9% of
children in the active treatment group met criteria for positive treatment
response post-treatment compared to only 9.1% of children in the waitlist
condition. In addition, 80% of children in the active treatment group were
diagnosis free at follow up. From these results, it is reasonable to draw the
conclusion that with specific modifications, CBT can be an effective treatment
for children with ASD and comorbid (concurrent) anxiety disorders.

implications

The above referenced
study, together with case studies and other clinical trials, provides evidence
that incorporating disorder specific hierarchies, use of more concrete, visual
tactics, incorporation of child specific interests, and parental involvement can
facilitate successful results when conducting CBT for anxiety in children with ASD.
Although there is support for the efficacy of an enhanced CBT program, there
are some limitations to these modifications and adapted models. Specifically, the
child’s level of functioning, variation in the use of each modification, and
the utilization of different CBT programs across studies affect the
generalization of the outcomes. Moreover, there is a need to examine to what
extent CBT with these modifications could be used with more severe cases of ASD
or in cases where there is more severe intellectual impairment. Children with
higher functioning ASD may be able to better process the cognitive components
of traditional and modified CBT than those who are lower functioning.
Additionally, different CBT programs may emphasize different components of CBT
making it difficult to determine which components are the most critical for
treating anxiety in children with ASD. The next step for future research should
be to focus on developing a standardized approach to treatment which
incorporates specific modifications, randomized clinical trials to test the
approach, and explorations of the boundaries within the ASD population for use
and effectiveness of treatment. Given the elevated comorbidity rates, finding
an effective, empirically supported treatment for anxiety in children with ASD
is critical.

Tuesday, November 5, 2019

Research is advancing
our understanding of the nature of childhood stress and trauma in autistic
individuals and its subsequent impact on mental health and wellbeing. The DSM-5
notes that psychological distress associated with stress and trauma is varied
and may include anxiety or fear-based reactions, changes in mood, anger,
irritability, aggression or dissociation. Although there is a specific
diagnostic category for trauma and stressor-related disorders, stress and
trauma are identified as risk factors for several other disorders including
depression and anxiety.

An important development
in understanding the impact of stress and trauma on mental health in the
general population has been the adverse childhood experience (ACE) studies. Adverse childhood
experiences (ACEs) are potentially traumatic events that can have negative,
lasting effects on health and well-being. The more adversities an individual
has experienced, the higher the likelihood that individual will have serious
mental and physical health problems later in life. ACEs include all types of abuse, neglect, and
other stressful and traumatic experiences (e.g., bullying, peer rejection, neighborhood
violence, poverty, financial hardship, parental divorce, incarceration, death,
domestic violence, household substance abuse problems, and family mental health
concerns).

Trauma and ACEs in Autism

There is mounting evidence
for stress and trauma as a risk factor for comorbidity and the worsening of the
core symptoms in ASD. These findings are consistent with research on the
psychological consequences of adverse childhood experiences (ACEs) in the
general population. A recent study to identify rates of ACEs in autistic children found that a diagnosis of ASD was significantly associated with a higher
probability of reporting one or more ACEs. The number of children with ASD who
were exposed to four or more ACEs was twice as high compared to their typically developing peers.

The core symptoms of ASD
may themselves predispose children to stressful and traumatic situations. For
example, difficulty with socialization could lead to increased social anxiety
or peer rejection. Experiences known to be distressing for autistic individuals
such as unexpected schedule changes, the prevention or discouragement of
repetitive or preferred behaviors, and sensory sensitivities, could be
perceived as traumatic particularly when such distress occurs on a consistent
basis, adding to the potential for comorbidity. These core symptoms would
makeevery day social situations and new
or unexpected experiences highly stressful for someone with ASD. It is possible
that consistent rumination on stressful or traumatic experiences could lead to co-occurring
symptoms of depression, anxiety or even PTSD if a significant traumatic event
has taken place.

Implications

Research suggests that autistic
individuals may be at high risk for experiencing stressful and traumatic life
events, the consequences of which can negatively impact mental health through
the development of comorbid disorders (e.g., anxiety, depression) and/or worsening of the core symptoms of
ASD. Exposure to stressful and potentially traumatic events may manifest as
symptoms of aggression, difficulty concentrating, social isolation, increased
relational difficulties, regression in daily living skills, and increased
repetitive or stereotypic behavior. As many of these symptoms are commonly
associated with ASD, the stress and/or trauma underlying these symptoms may go untreated. Stressful and traumatic life events should be considered by mental health professionals when conducting assessments and determining appropriate treatment plans for autistic individuals experiencing comorbid symptomatology and or/an exacerbation of core ASD symptoms to help ensure that underlying causes of these symptoms are not overlooked. Formal screening and identification of ACEs can lead to trauma-informed
interventions and treatment goals that can help to mitigate negative outcomes
while promoting an environment that is supportive and affirmative of the
experience of having ASD.

Wednesday, October 2, 2019

There is a long history of reports of individuals who despite having severe intellectual impairments, demonstrate remarkable skills in a particular area. The term “savant” has been variously defined asthose individuals who show (a) normatively superior performance in an area and (b) a discrepancy between their performance in that area and their general level of functioning.Some researchers have differentiated “prodigious” savants (e.g., individuals possessing an exceptional ability in relation to both their overall level of functioning and the general population) from “talented” savants (e.g., individuals showing an outstanding skill in comparison with their overall level of functioning).

Savant skills have been reported much more frequently in males than in females and have been identified in a wide range of neurological and neurodevelopmental disorders. The most commonly reported savant skills are mathematical skills (calendrical calculations, rapid arithmetic and prime number calculations), music (especially the ability to replay complex sequences after only one exposure), art (complex scenes with accurate perspective either created or replicated following a single brief viewing) and memory for dates, places, routes or facts. Less frequently reported are “pseudo-verbal” skills (hyperlexia or facility with foreign languages), coordination skills and mechanical aptitude.

Research

Research in the past 10 years
has generated some controversy about the actual incidence of savant syndrome in
autism. Once thought to be rare in
people with autism, found in no more than 1 out of 10 individuals, research
over the past few years suggests savant skills may be more common than previous
estimates. Although there have been many single case or small group studies of individuals with autism who possess savant abilities or exceptional cognitive skills, there have been few systematic, large-scale investigations in this area. Inconsistencies in definition and wide variation in diagnostic criteria, ages and ability levels of the cases reported are problematic, as is a paucity of valid information on rates of savant skills in ASD.The objective of this research study was to investigate the nature and frequency of savant skills in a large sample of individuals with autism who had been initially diagnosed as children.

The total sample was comprised 137 individuals, first diagnosed with autism as children, who were subsequently involved in an ongoing, longitudinal follow-up study. Cognitive assessments (Wechsler Scales) were completed for all participants (100 males and 37 females) between the ages of 11 and 48 years (mean age of 24). Parental report data on savant skills were obtained approximately 10 years later at a subsequent follow-up. Cognitive ability ranged from severe intellectual impairment to superior functioning. Savant skills were judged from parental reports and specified as “an outstanding skill/knowledge clearly above participant’s general level of ability and above the population norm.”

Results

Of the 93 individuals for whom parental questionnaire and cognitive data were available, 16 (17.2%) met criteria for a parent-rated skill, 15 (16.8%) had an exceptional cognitive skill and 8 (8.6%) met criteria for both. There were 14 calendrical calculators (one also showed exceptional memory and another also showed skill in computation and music). There were four others with computational skills (in one case combined with memory and in another case with music). Visuospatial skills (e.g., directions or highly accurate drawing) were reported in three individuals. One individual had a musical talent, one an exceptional memory skill and one had skills in both memory and art.The subtest on which participants were most likely to meet the specified criteria for an area of unusual cognitive skill was block design followed by digit span, object assembly and arithmetic.

There was a sex difference (albeit statistically non-significant) in the prevalence of savant skills. Almost one-third (32%) of males showed some form of savant or special cognitive skill compared with 19 percent of females. No individual with a non-verbal IQ below 50 met criteria for a savant skill and contrary to some earlier hypotheses; there was no indication that individuals with higher rates of stereotyped behaviors/interests were more likely to demonstrate savant skills.

Discussion

In total, 39 participants (28.5%) met criteria for a savant skill. Cognitively, 23 individuals (17% of total sample) met criteria for one or more exceptional area of skill on the Wechsler Scales. Combining the two, 37 per cent of the sample showed either savant skills or unusual cognitive skills or both, a far higher proportion than previously reported. These results suggest that the rates of savant skills in autism are significant, particularly among males, and although these estimates are higher than reported by other researchers, the findings parallel those of previous studies. Based on these findings, it appears likely that at least a third of individuals with autism show unusual skills or talents that are both above population norms and above their own overall level of cognitive functioning. It should be noted that these data offer no support to claims that savant skills occur most frequently in individuals with autism who are intellectually challenged or that individuals with higher rates of stereotyped behaviors/interests are more likely to demonstrate savant skills.

Implications

Apart from the need for further research examining the underlying basis of savant skills and why certain individuals go on to develop any area of exceptional skill and why these skills encompass such different areas, there is a more practical and pressing question; “how can these innate talents be developed to form the basis of truly ‘functional’ skills?” In the present study, only five individuals with exceptional abilities (four related to math and one related to visuospatial ability) had succeeded in using these skills to find permanent employment. For the majority, the isolated skill remained just that, leading neither to employment nor greater social integration. As the authors conclude, “The practical challenge now is to determine how individuals with special skills can be assisted, from childhood onward, to develop their talents in ways that are of direct practical value (in terms of educational and occupational achievements), thereby enhancing their opportunities for social inclusion as adults.”

Wednesday, August 7, 2019

Students throughout the country will soon be making the transition to a new school year. This includes an increasing number of special needs children identified with autism spectrum disorder (ASD). Since Congress added autism as a disability category to the Individuals with Disabilities Education Act (IDEA) in 1990, there has been a dramatic increase in the number of students receiving special education services under this category. In fact, the number of students
receiving assistance under the special education category of autism over the
past decade has increased from 1.5 percent to 9 percent of all identified
disabilities. Autism now ranks fourth among all IDEA disability categories for
students age 6-21.

The beginning of a new school year is an exciting yet anxious time for both parents and children. It typically brings a change in the daily routine established over the summer months. Although transitioning back to school can be especially challenging for children on the autism spectrum, the following tips will help parents prepare them for a new school year. 1. Prepare and reintroduce routines.

Familiarize and reintroduce your child to the school setting. This may mean bringing your child to the school or classroom, showing your child a picture of their teacher and any classmates, or meeting the teacher before the first day of school. If possible, arrange to visit the teacher or the school a week or two before the first day. If this isn’t feasible, visit the school building or spend some time on the playground. Driving by the school several times is another good idea. You may also want to drive your child on the first day if they ride a bus to school. For many children, riding a bus to school on the first day can result in a sensory “overload.” Ask to meet the bus driver so your child feels
comfortable riding the bus. You might even ask if you and your
child can do a ride-along to the school. Gradually easing into the transportation routine will be helpful for everyone.

2. Review your child's Individualized Education Plan (IEP).

The IEP is a legal document and the
cornerstone for your child’s education. It includes academic goals,
appropriate accommodations and modifications and a description of all
specific special education and related services, including individualized
instruction and related supports and services (e.g., counseling,
occupational, physical, and speech/language therapy; transportation),
together with the specific setting in which the services will be provided.
Parents should always have the IEP available to reference this essential
information throughout the school year. If you do not have a copy, request
one from the Special Education/Services Department in your school district.

If appropriate, make certain a behavior intervention plan (BIP) is in place the first day of school. If your child has a plan that’s been effective, ask that it
be shared with his or her new teacher and implemented immediately at the start
of the year.

3.Expect the unexpected.

Parents cannot anticipate everything that might happen during the school day. Allow more time for all activities during the first week of school. Prepare your child for situations that may not go as planned. Discuss a plan of action for free time, such as lunch and recess. Use social stories to familiarize your child with routines and how to behave when an unexpected event occurs. Anticipate sensory overload. The activity, noise and chaos of a typical classroom can sometimes be difficult to manage. Establish a plan of action for this situation, possibly a quiet room where the child can take a short break. If your child has dietary issues, determine in advance how this will be managed so as to avoid any miscommunication.

4.Review and teach social expectations.

Although many children may transition easily between the social demands of summer activities and those required in the classroom, children on the autism spectrum may need more clear-cut (and literal) reminders. Review the “dos and don’ts” of acceptable school behavior. You can also create a schedule of a typical school day by using pictures and talk about how the school day will progress. Create a social story or picture schedule for school routines. Start reviewing and practicing early. If possible, meet with teachers and administrators to discuss your child’s strengths and challenges. Remember, you are your child’s best advocate. Establish tech-based or written communication early to develop positive relationships with your child’s teacher and school. Volunteer opportunities, open houses,
parent-teacher conferences, and after-school events are ways you can apply
in-person communication. Rehearse new classroom activities. Ask the teacher what new activities are planned for the first week. Then, prepare your child by performing, practicing, and discussing them. This rehearsal will reduce anxiety when new activities take place during the beginning of school.

Tuesday, July 9, 2019

Controversial
therapies and interventions continue to be a significant part of the history of
children and youth with autism, perhaps more so than any other childhood
disorder. Unfortunately, families are often exposed to unsubstantiated,
pseudoscientific theories, and related clinical practices and therapies that are
ineffective and compete with validated treatments, or that have the potential
to result in physical, emotional, or financial harm. Many treatments are
recommended to families based on anecdotal reports that make exaggerated
claims, often appearing on the internet or in the popular media that do not
qualify as scientific research. Given that autism has no known cure, parents
and advocates will understandably pursue interventions and treatments that offer
the possibility of helping the child with autism, particularly if they are
perceived as unlikely to have any adverse effects and are generally accepted or
popularized.

CAM Therapies

Complementary and alternative medicine (CAM), also called
integrative medicine, is an approach widely used by families caring for
individuals with autism. CAM
is defined as “a group of diverse medical and health care systems, practices,
and products that are not presently considered to be part of conventional
medicine.” Current research estimates that between
30 and 95 percent of children with autism spectrum disorder (ASD) have
tried complementary or alternative medicine therapies, and up to 10% may be
using a potentially dangerous treatment. The most commonly used CAM treatments for ASD fall into the
categories of "biological" and “non-biological.” Examples of biological therapies include immunoregulatory interventions (e.g., dietary restriction of food allergens or administration of immunoglobulin or antiviral agents); detoxification therapies (e.g., chelation); stem-cell therapy; hyperbaric oxygen therapy (HBOT); gastrointestinal treatments (e.g., digestive enzymes, antifungal agents, probiotics, and gluten/casein-free diet); cannabidiol (CBD), and dietary supplement regimens (e.g., vitamin A, vitamin C, vitamin B6 and magnesium, folinic acid, vitamin B12, dimethylglycine and trimethylglycine, carnosine, omega-3 fatty acids, inositol, and various minerals). Non-biological interventions include treatments such as auditory integration training; sensory
integration therapy; neurofeedback; pet therapy; massage therapy; aromatherapy; behavioral optometry;
craniosacral manipulation; acupuncture; chiropractic treatment, and facilitated
communication. These CAM therapies are generally described as pseudoscience and typically involve claims of scientifically supported
evidence, which is in fact, lacking or misinterpreted.

At present, the empirical and treatment
literature does not support and recommend the use of either biological or
non-biological CAM treatments for children with ASD. Overall, there is sparse
evidence on the usefulness of CAM treatments with autism. Although some CAM
practices appear to have emerging evidence to support their use in traditional
medical practice (i.e., melatonin), there are no CAM interventions with
sufficient evidence to suggest they are effective. The most extensively
evaluated biological CAM treatment for autism, the hormone secretin, has been
thoroughly evaluated and shown to be ineffective with respect to core symptoms
of ASD, including self-stimulatory behaviors, impaired communication,
restrictive and repetitive behaviors, and gastrointestinal problems.Additionally, research does not support the
use of biological detoxification therapies such as chelation for ASD. According
to the U. S. Food and Drug Administration, there are serious safety
issues associated with chelation products. Similarly, the FDA has announced
that hyperbaric oxygen treatment (HBOT) is not an approved or effective
treatment for autism.

Implications

Unfortunately, pseudoscience is commonly practiced with ASD. Professionals in clinical and school
contexts play an important role in helping parents and caregivers to
differentiate empirically validated treatment approaches from treatments that
are unproven and potentially ineffective and/or harmful. The major risk of CAM
treatments is not only the potential for harm (e.g., chelation products), but
the time and resources devoted to ineffective therapies at the expense of
evidence-based interventions that have demonstrated effectiveness. The time, effort, and financial resources spent on pseudo and ineffective treatments can
create an additional burden on families. All treatment selections should be
evidence-based and include peer-reviewed studies with
well-defined populations, randomized, large samples, control for confounding
factors, and the use of validated outcome measures. There are
few peer-reviewed, well-controlled, independent studies about CAM therapies,
both for autism and many other health conditions. The paucity of validated,
evidence-based data limits the ability to make fully
informed decisions about the appropriateness of these treatments, particularly
when considering that some CAM therapies are initiated without the guidance of a
medical professional. More methodologically sound research needs
to be completed on CAM treatments, and this information disseminated to
families by well-informed professionals, so that parents can make educated
judgments in selecting interventions. Parents and professionals should
exercise caution when considering interventions and treatments that (a) are
based on overly simplified scientific theories; (b) make claims of recovery
and/or cure; (c) use case reports or anecdotal data rather than scientific
studies; (d) lack peer-reviewed references or deny the need for controlled
research studies; or (e) are advertised to have no potential or reported
adverse effects.

American Academy
of Pediatrics, Section on Complementary and Integrative Medicine and Council on
Children with Disabilities, Policy Statement (2012). Sensory integration
therapies for children with developmental and behavioral disorders. Pediatrics,
1186-1189. doi: 10.1542/peds.2012-0876.

Hopf, K. P.,
Madren, E., & Santianni, K. A. (2016). Use and Perceived Effectiveness of
Complementary and Alternative Medicine to Treat and Manage the Symptoms of
Autism in Children: A Survey of Parents in a Community Population. Journal
of alternative and complementary medicine (New York, N.Y.), 22(1),
25–32. doi:10.1089/acm.2015.0163

National Research Council (2001). Educating children with autism. Committee on Educational
Interventions for Children with Autism. C. Lord & J. P. McGee (Eds).
Division of Behavioral and Social Sciences and Education. Washington, DC:
National Academy Press.

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